Provider Demographics
NPI:1093171944
Name:LIGONS, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LIGONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8725 S NORMAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-2119
Mailing Address - Country:US
Mailing Address - Phone:773-945-1479
Mailing Address - Fax:
Practice Address - Street 1:477 E BUTTERFIELD RD STE 310
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4880
Practice Address - Country:US
Practice Address - Phone:773-945-1479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71009202103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist